PSTPRNDIAL THRMOGNESIS&ENRGTIC CONSEQNCES OF OVRFEED IN PTS W/HIV LIPODYSTROPHY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. HIV lipodystrophy is a recently described disorder in which patients with HIV infection develop a variety of problems with their adipose tissue. This includes a loss of subcutaneous fat and an increase in deep abdominal fat. These changes in the adipose tissue organ are usually accompanied by insulin resistance which can lead to diabetes mellitus and changes in blood lipids including high cholesterol and triglyceride levels. We have found that patients with HIV lipodystrophy also have increased basal metabolic rates. In other words, they expend more calories at rest than do HIV-infected patients without lipodystrophy and healthy individuals. This accelerated metabolic rate could be a problem in times of intercurrent illness when the appetite typically falls. Patients with HIV lipodystrophy may therefore be at risk for severe weight loss in these times. It is unclear why patients with HIV lipodystrophy are hypermetabolic. One possibility is that they do not have enough storage capacity because they have lost their subcutaneous fat. We therefore plan to put patients with HIV lipodystrophy on a short-term (3 days), high-calorie diet and determine if basal metabolic rate increases significantly. If this is the case, it would imply that patients with this syndrome are able to increase energy expenditure in response to caloric intake that exceeds their ability to store the calories. This research would further understanding of weight regulation in general.